Blood groups are frequent targets in epidemiological investigations since they are genetically determined traits with known polymorphic expression among individuals and populations. Since the discovery of the ABO blood group, there has been an ongoing interest in the potential role of blood groups in infectious disease. Finally, there is a symbiotic relationship between blood group expression and maturation of the gastrointestinal microbiome. Microorganisms can also stimulate antibodies against blood group antigens, including ABO, T, and Kell. Several distinct phenotypes associated with increased host resistance to malaria are overrepresented in populations living in areas where malaria is endemic, as a result of evolutionary pressures. Several blood groups can modify the innate immune response to infection. In addition, many blood group antigens facilitate intracellular uptake, signal transduction, or adhesion through the organization of membrane microdomains. Blood groups can play a direct role in infection by serving as receptors and/or coreceptors for microorganisms, parasites, and viruses. Differences in blood group antigen expression can increase or decrease host susceptibility to many infections. At present, there are 34 recognized human blood groups and hundreds of individual blood group antigens and alleles. Blood group antigens represent polymorphic traits inherited among individuals and populations.
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